Osteochondrosis is a degenerative-dystrophic lesion of the spine, which leads to the destruction of intervertebral discs with corresponding consequences. Osteochondrosis "infects" the entire spine, but the symptoms of the disease are more pronounced when the cervical region, as it is the most mobile, and the lumbar region are affected. The thoracic region suffers least.
The signs of cervical osteochondrosis are very diverse and often resemble other diseases, which makes differential diagnosis and early recognition of the pathology difficult. In this article we will look in detail at how osteochondrosis of the cervical spine manifests itself and what will help you suspect this disease.
Degrees of osteochondrosis
Osteochondrosis is a chronic progressive disease that occurs with periods of remissions and exacerbations. Pronounced clinical symptoms do not appear immediately, but after some time, when the degenerative process enters the 2nd or even 3rd stage.
There are only 4 degrees of pathology:
- The initial phase is characterized by pathological changes within the intervertebral disc. It loses moisture, which leads to degenerative changes, a decrease in disc height and cracks in the fibrous capsule. As a rule, there is no signage at this stage. Diagnosis is only possible through an MRI of the spine. This is the most favorable stage for starting treatment, as in this case it is possible to completely restore damaged discs, which cannot be done in the future.
- 2nd degree osteochondrosis is characterized by worsening damage to the intervertebral discs. Its height decreases significantly, which leads to sagging of the muscles and ligaments of the spine. All this causes instability of the injured segment of the spine, increased mobility of the vertebrae, their displacement and sliding relative to each other and in relation to the spinal axis. As a rule, it is at this stage that the first signs of the disease appear in the form of pain and other signs specific to cervical spine injuries.
- In the 3rd stage, protrusions and hernias of intervertebral discs develop. The symptoms of the disease are fully expressed.
- The 4th stage is the final. In this case, the formation of osteophytes and deformities of the spine occurs. The body tries to somehow stabilize the damaged segment of the spine, which is why osteophytes develop, ossification of ligaments and other processes that lead to stabilization of the vertebrae, but, unfortunately, this process is accompanied by vertebral subluxations and various types and degrees of spinal deformities.
The nature of the symptoms of cervical osteochondrosis
Manifestations of osteochondrosis in the cervical spine are associated with 3 mechanisms of negative impact of this pathology:
- Direct compression of the spinal cord, which passes through the spinal canal. It should be noted that this happens very rarely with an advanced degenerative process and its complications. Compression of the nervous tissue of the spinal cord can be caused by a large intervertebral hernia protruding directly into the lumen of the spinal canal; stenosis (narrowing) of the spinal canal due to degenerative changes; dislocations, subluxations, fractures of damaged vertebrae.
- Negative effect on the structures of the peripheral nervous system (roots of the spinal cord and nerve fibers) leaving the cervical spine. They can be compressed between adjacent vertebrae or herniated bulges and can become inflamed and irritated. All of this leads to a series of serious symptoms. This is the most common group of signs of cervical osteochondrosis.
- Negative effect on blood vessels passing near the damaged area of the spine. In particular, a very important arterial vessel is of clinical importance - the vertebral artery, which passes through the openings of the transverse processes of the cervical vertebrae into the cranial cavity and supplies blood to the posterior third of the brain and the cerebellum.
Let's consider in detail each group of mechanisms and what symptoms they cause.
Symptoms associated with spinal cord injury
As already mentioned, spinal cord compression in cervical osteochondrosis is very rare. This is a very serious condition that can cost a person not only their health, but also their life.
Damage to the upper cervical spine is fatal. The cardiovascular and respiratory centers suffer, which leads to immediate death. With compression at the level of the 3-4 segment of the spinal cord, tetraplegia develops (paralysis of all limbs and muscles below the lesion). The respiratory muscles and diaphragm also suffer, which can lead to respiratory arrest and death.
If damage occurs at the level of the 4th to 5th segment of the spinal cord, quadriplegia develops, but without respiratory compromise. When 5 to 8 segments of the spinal cord are compressed, several muscle groups of the upper extremities suffer and paraparesis of the legs and rupture of the pelvic organs occur.
Symptoms associated with nerve damage
pain syndrome
First of all, pain syndrome should be noted, which can be chronic (neck pain) and acute in the form of low back pain (neck pain). The pain occurs in the neck, occipital part of the head and shoulder girdle. It is usually caused by irritation, compression and inflammation of the nerve roots of the cervical spine, as well as pathological spasm of the muscles in this area, which are innervated by these nerves.
The pain associated with neck pain is almost constant, painful and varies in intensity. As a rule, the pain syndrome can be tolerated. It appears or intensifies with sudden movements, turns and tilts of the head. Movements in the neck are accompanied by a characteristic crunching sound.
Neck pain occurs suddenly in the form of a gunshot or electric shock. It's very intense, it goes to one hand. It lasts for a few seconds or minutes and then gives way to neck pain. It is usually caused by sudden movement and compression of the nerve.
Radicular syndromes
All of the major nerves of the upper extremity (median, ulnar, and brachial) are formed from nerve fibers that emerge from the cervical spine. Thus, in the presence of cervicobrachial osteochondrosis, these nerve structures may suffer. All of these nerves are mixed, that is, they have sensory and motor functions. Depending on which root is affected, the symptoms will be different. For example, sensation in the second or third fingers may be lost and paralysis of one or more muscles may occur. All these signs of nerve damage are classified into separate syndromes, which only a neurologist can determine.
Occipital neuralgia
Occipital neuralgia develops when the greater and lesser occipital nerves, which are formed by the 2nd, 3rd, and 4th pairs of cervical spinal nerves, are damaged. When these structures become compressed, irritated or inflamed due to a degenerative process in the spine, a headache occurs in the back of the head, which women often complain about.
This pain is so typical that only its description allows a correct diagnosis in 90% of cases. It is also called acute cranialgia. An attack of pain occurs suddenly, has a unilateral localization (it rarely hurts on both sides), patients compare the nature of the pain to an electric shock. The attack lasts several minutes but can be repeated several times a day. The pain occurs on the posterolateral surface of the neck and spreads upward to the occipital protuberance (repeats the anatomical course of the occipital nerve). At the same time, a sensitivity disorder may develop in the skin on the back of the neck (numbness, tingling sensation).
cardiac syndrome
This name is due to the fact that this manifestation of osteochondrosis of the cervical spine is very similar to angina pectoris and other heart diseases. The reason for this phenomenon is damage to the nerve fiber innervating the pectoralis major muscle and the phrenic nerve, the fibers of which are woven into the pericardium of the heart.
The cause of pain is spasm of the pectoralis major muscle due to pathological impulses along the damaged nerve fiber. At the same time, patients often confuse this pain with heart pain. Unlike coronary pain, the pain syndrome in cervical osteochondrosis lasts for a long time (sometimes several hours or days), which does not happen in angina pectoris, and is not associated with physical activity, but is related to body position. The pain intensifies with sudden movements, turning the head, coughing, sneezing, which does not happen in angina pectoris. Antianginal medications (nitroglycerin, etc. ) will not be effective.
Important! In any case, such symptoms require a thorough differential diagnosis, since atypical variants of angina and heart attack also occur. In order not to miss a serious illness, you first need to do an ECG. In osteochondrosis, no pathological changes will be recorded.
Symptoms associated with vertebral artery injury
Compression of the vertebral artery during cervical osteochondrosis can cause a large number of unpleasant manifestations, which are mainly associated with a decrease in blood flow and hypoxia of the part of the brain that is fed by this vessel (the posterior third of the brain and the cerebellum) .
Signs of vertebral artery syndrome:
- headache of a diffuse or pulsating nature in the back of the head, temples and parietal region;
- dizziness;
- nausea and vomiting;
- visual disturbances;
- ringing in the ears, decreased hearing acuity;
- impaired coordination and balance;
- development of falling attacks (sudden falls without loss of consciousness due to sudden turns of the head);
- memory impairment, decreased performance, ability to concentrate.
Important to remember! With pronounced changes in the spine, the artery can be compressed so much that this will lead to the development of ischemic stroke in the vertebrobasilar region of the brain. Therefore, it is important to suspect pathology in time and take all necessary measures to improve spinal health and prevent further pathological changes.
Common questions
What symptoms accompany cervical osteochondrosis?
Symptoms of cervical osteochondrosis may include pain and stiffness in the neck, headaches, dizziness, tinnitus, and tingling or numbness in the arms and shoulders.
How can you alleviate the symptoms of cervical osteochondrosis?
To alleviate the symptoms of cervical osteochondrosis, it is recommended to practice physical exercises, maintain correct posture, avoid sitting in the same position for a long time, use special pillows and mattresses and also use physiotherapeutic methods.
Useful Tips
Tip #1
Pay attention to pain in the neck, shoulders and arms, which may be symptoms of cervical osteochondrosis. The pain can be sharp, dull or localized to certain points.
Tip #2
Pay attention to numbness or weakness in the arms, fingers or shoulders, as this can also be caused by cervical osteochondrosis.
Tip #3
Pay attention to headaches, dizziness and tinnitus, as these symptoms can also be associated with cervical osteochondrosis.